The 10-year outcomes of a regional abdominal aortic aneurysm screening program

Abstract

Objective: In 2007, Medicare established ultrasound screening guidelines to identify patients at risk for abdominal aortic aneurysm (AAA). The purpose of this study was to evaluate AAA diagnosis rates and compliance with screening during 10 years (2007-2016) of the Screen for Abdominal Aortic Aneurysms Very Efficiently Act implementation within a regional health care system. Methods: A retrospective chart review of all patients screened for AAA from 2007 to 2016 within a regional Veterans Affairs health care system was conducted. Screening criteria were men 65 to 75 years of age who smoked a minimum of 100 cigarettes in their lifetime. An AAA was defined as a maximum aortic diameter ≥3 cm. A comparison was made of the AAA diagnosis rate and clinical adherence rate of screening criteria between the first 5 years and total years evaluated. AAA-related mortality was identified by using terminal diagnosis notes or autopsy reports. All data were recorded by August 31, 2017.

Aneurysms and dissections - What is new in the literature of 2019/2020 - a European Society of Vascular Medicine annual review

“…In these guidelines a slight decrease of aneurysm prevalence has been described probably caused by change in smoking habits. This is supported by the results from a recent publication [2]. In this retrospective study, the 10-year outcomes of an abdominal aortic aneurysm (AAA) screening program by a regional Veterans Affairs health care system was evaluated.…”

Screening Older Adult Men for Abdominal Aortic Aneurysm: A Scoping Review

“…Confirming this trend, the 10-year outcome evaluation of the American veterans’ AAA screening program reported fewer large AAAs had been detected in the last 5 years of the study, and overall, more but smaller (3.0–4.4 cm) aneurysms were being detected. In addition, the 10-year rate of AAA diagnosis had declined from 7.2% to 6.3% in the first 5 years with patients expected to outlive their predicted 11-year life expectancy ( Chun et al, 2019 ).…”

“… McCaul et al (2016) concluded that screening men aged 65–74 years old for AAA was ineffective because AAA mortality was not significantly reduced, due to lower than expected AAA mortality rates in a cohort of non-screened men. Related to this issue, Chun et al (2019) predicted that because more men were being detected with smaller AAAs at younger ages, increased annual surveillance would likely burden health institutions in the United States. Furthermore, Johansson et al (2018) doubted the benefits of an AAA screening program, as decreasing rates of rAAA and AAA mortality were seen in the older adult male population, regardless of screening.…”

Screening for Abdominal Aortic Aneurysms and Risk Factors in 65-Year-Old Men in Oslo, Norway

“… 9 , 16 In the United States, one-time screening for AAA has been offered since 2007 to male members of Medicare between the ages of 65 to 75 years with any history of smoking. 17 …”

“…9,16 In the United States, one-time screening for AAA has been offered since 2007 to male members of Medicare between the ages of 65 to 75 years with any history of smoking. 17 In Sweden, the prevalence of AAA in 65-year-old men is 1.5%. 9 The national screening program in the United Kingdom has shown a AAA prevalence in ≥65-year-old men at 1.57%.…”